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NAPLEX > Dyslipidemia > Flashcards

Dyslipidemia Flashcards

1
Q

LDL Formula

A

TC - HDL - (TG/5)

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2
Q

Drugs that Raise LDL/TG

A
  • Diuretics
  • Efavirenz
  • Steroids
  • Immunosuppressants (tacrolimus/cyclosporine)
  • Atypical antipsychotics
  • Protease Inhibitors
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3
Q

Drugs that raise LDL Only

A

Fish Oils

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4
Q

Drugs that Raise TG Only

A
  • IV Lipid emulsions
  • Propofol
  • Bile Acid Sequestrants (~5%)
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5
Q

Indications for High Intensity Statin

A
  • Clinical ASCVD (CHD, stroke, TIA, PAD)
  • LDL >= 190
  • Diabetes between 40-75 yo with LDL 70-189 and multiple ASCVD risk factors
  • Age 40-75 yo with LDL 70-189 and 10-yr risk >=20%
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6
Q

Statin Equivalent Doses

A

Pharmacists Rock At Saving Lives and Preventing Flu

  • Pitavastatin 2 mg
  • Rosuvastatin 5 mg
  • Atorvastatin 10 mg
  • Simvastatin 20 mg
  • Lovastatin 40 mg
  • Pravastatin 40 mg
  • Fluvastatin 80 mg
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7
Q

High-Intensity Statin Doses

A
  • Atorvastatin 40-80 mg

- Rosuvastatin 20-40 mg

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8
Q

Low-Intensity Statin Doses

A
  • Pitavastatin 1 mg
  • Simvastatin 10 mg
  • Lovastatin 20 mg
  • Pravastatin 10-20 mg
  • Fluvastatin 20-40 mg
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9
Q

CYP3A4i Interaction

A

G PACMAN

  • Grapefruit, PI, azole antifungals, cobicistat/cyclosporine, macrolides - CI with sim and lovastatin
  • Amiodarone: Simvastatin max of 20 mg/day and Lova 40 mg/day
  • Non-DHP CCBs: Simvastatin max of 10 mg/day and Lova 20 mg/day
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10
Q

Indications for Moderate Intensity Statins

A
  • Diabetes between 40-75 yo with LDL 70-189 regardless of ASCVD risk factors
  • Age 40-75 yo with LDL 70-189 and 10-yr risk 7.5-19.9%
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11
Q

High Risk Lab Values that REQUIRE Tx

A
  • LCL >= 190

- TG >= 500

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12
Q

Goal LDL Levels

A

<100

Severe if >= 190

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13
Q

Goal HDL Levels

A
  • > 50 for women

- >40 for men

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14
Q

Goal TG Levels

A

-<150

Severe if >= 500

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15
Q

Factors for ASCVD Risk

A
  • Age
  • Race
  • TC
  • HDL
  • SBP (and if HTN meds used)
  • Diabetic status
  • Smoking status
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16
Q

Liver Damage + Cholesterol Meds

A

Don’t use if AST or ALT is >3x ULN:

  • Niacin
  • Fibrates
  • Statins
  • Ezetimibe
17
Q

Cyclosporine DDI

A
  • Rosuvastatin max of 5mg/day

- CI with lova and simvastatin

18
Q

Cobicistat DDI

A
  • Atorvastatin max of 20 mg/day

- CI with lova and simvastatin

19
Q

General Statin SE

A

Think HMG:

  • Hepatoxicity
  • Myalgias
  • Glucose changes (increased A1C/BG)
20
Q

Ezetimibe

A
  • Preferred add-on agent to statins
  • SE: Myalgia risk (can increase rhabdo-risk)
  • Hepatotoxic risk as well
  • CI in preggo/BF too
21
Q

PCKS9i

A
  • 2nd choice for add-on agents to statins
  • Lower LDL SIGNIFICANTLY but are expensive and inj
  • Both are SQ
  • EX: Praluent and Repatha
  • SE: Injection site rxns
22
Q

Bile Acid Resins

A
  • Ex: Welchol (Colesevelam)
  • Take with meal and liquid
  • Potential cholesterol option for preggo
  • Can also be used for glycemic control in T2DM
23
Q

Bile Acid Resin SE

A
  • Can cause teeth discoloration/decay
  • CI: bowel obstruction
  • SE: constipation, abdominal pain, cramping, gas, increased TG (~5%)
24
Q

Fibrate Brand Names

A
  • Antara
  • Tricor
  • Trilipix
  • Lipofen - take with meals
  • Fenoglide - take with meals
25
Q

Lopid

A
  • Gemfibrozil
  • Fibrate
  • CI: use with statin or ezetimibe (severe rhabdomyolysis risk)
26
Q

Fibrate Information

A
  • CI: severe liver disease (primary biliary cirrhosis), BF, severe renal disease, or gallbladder disease
  • Warning: myopathy risk (esp. when given with statin)
  • SE: Dyspepsia (more with gemfibrozil) and increased LFTs
27
Q

Niacin Formulation Options

A
  • IR, CR/SR, ER
  • IR (Niacor) - increased risk of flushing, can premedicate with ASA
  • CR/SR: less flushing, more hepatotoxicity
  • ER (Niaspan) - less flushing risk and hepatoxicity
  • *NOT INTERCHANGEABLE**
  • ALL take with food, but ER formulation take QHS with low-fat snack
28
Q

Niacin Information

A
  • Warning: rhabdo, hepatoxicity, increased BG and UA
  • SE: flushing, pruruitis, vomiting, diarrhea, increased BG/UA
  • Avoid spicy food, alcohol, and hot beverages with meds since it could worsen flushing
  • Can premedicate with high-dose ASA to help with flushing if desired
29
Q

Lovaza

A
  • Omega-3: fish oil for TG >= 500
  • Warning: avoid with fish/shellfish allergies
  • SE: burping, dyspepsia, taste perversion
  • Can increase LDL
  • Prolonged bleeding time (monitor INR in warfarin pts)
30
Q

Vascepa

A
  • Icosapent ethyl: fish oil for TG>=500
  • Warning: avoid with fish/shellfish allergies
  • SE: burping, dyspepsia
  • LDL increase and taste perversion not seen with this option
  • Prolonged bleeding time (monitor INR in warfarin pts)
31
Q

Juxtapid

A
  • Lomitapide: injectable med for primary dyslipidemia
  • Box warning: hepatoxicity
  • CI: Liver disease and preggo
  • REMS program med

NAPLEX (59 decks)

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